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Pain, Pain Go Away: Texas Seeks A Choice Of Treatments For Chronic Pain Sufferers Part 3

Aug 18, 2007
Chronic pain will disable more people in the U.S. than cancer and heart disease combined this year. Between 75 and 90 million Americans deal with chronic pain, and approximately 25 million from acute pain that requires treatment. What is worse, perhaps, is that many pain sufferers never receive adequate relief: 40% of cancer patients don't, and neither do 50% of post-surgery patients. Texas is no exception. Prospering pain management clinics in every major city in the state, from Houston, to Austin, to Dallas reflect this reality.

Pain is classified as chronic when it has occurred either continually, or intermittently, over a period longer than six months. Conditions of chronic pain can lead to anxiety, fear, depression, lack of activity, and unemployment, not only causing suffering, but also costing the nation billions in lost working hours, medical charges, and workers' compensation.

The management of this condition, then, is arguably one of the more pressing health issues today throughout Texas and the rest of the United States. Particularly with the proper health insurance coverage, these conditions can be effectively treated, however, and, if not cured, at least managed.

While health institutions do their best to estimate statistics on pain, it's been difficult to gather accurate data, partially due to hospital policies related to its management.

Until this year, when the Joint Commission began enforcing new regulations, hospitals in Texas and the rest of the country were not required to monitor a patient's pain levels in the same manner as every other vital sign, which also made it difficult for health insurance policies to cover treatment. As a result, consistent pain data on any one condition, or after any particular procedure, was difficult to attain. Now, hospitals are required to do so, monitoring a patient's pain levels frequently from check-in to check-out. This change in policy will supply new, enlightening information on the experience and management of painful conditions.

According to Zena Quezado, chief of the Department of Anesthesia and Surgical Services at the National Institutes of Health Clinical Center, pain levels are associated with several variables, including patient experience, perception of pain, age, gender, and type of pain.

The reasons behind inadequate pain relief, she says, are still unknown, but may be partially attributed to "mind responses." Indeed, many health professionals agree that the psychological process is an important aspect of perceiving and managing pain. For some, it is a negative cycle of anxiety; worrying about the pain produces tension, which, in turn, tightens muscles and releases stress hormones, thereby increasing pain. For others, it is the perception of the pain that makes it unbearable.

This article will therefore explore some of the psychological aspects of, and treatments for, managing pain. In many instances, health insurance policies will cover treatments, particularly if referred by a qualified physician. Much of the information has been adapted from Prescriptions for Natural Healing by James F. Balch, M.D., and Phyllis A Balch, C.N.C. As always, consult a qualified health practitioner before undergoing any treatment.

(1) Biofeedback

Biofeedback operates on the principle that one can learn to control functions previously thought only involuntary, through the application of relaxation techniques and instant feedback regarding their efficacy. By monitoring responses such as heart rate and blood pressure, the idea is that the patient can modify his or her techniques in order to make them more effective. Biofeedback has proven effective in managing chronic pain situations in numerous experiments.

The method is relatively simple: Electrodes are (painlessly) attached to the skin, and the patient is instructed to practice a relaxation technique he or she is familiar with, such as meditation. The monitors then let the patient know if heart rate, blood pressure, skin temperature, pulse, muscle tension, and/or brain activity has decreased (or increased). Those biological responses can then be associated with pain level. It is believed that, over time, one can train himself/herself to make relaxation techniques more effective, use relaxation methods that best suit his or her needs, and train the body to be in that effective state more often on cue.

(2) Counseling

Counseling is an absolutely invaluable resource. Different pain levels experienced by members of different cultures during the same event provide interesting data on the effects of psychology. For instance, women in the United States are usually taught to fear childbirth for its levels of pain, while women in most European cultures are not. Not surprisingly, American women report higher levels of pain during childbirth and receive more anesthetic medications. The lesson: what we tell ourselves over time makes a big difference.

The right therapist will teach skills designed to help a chronic pain patient cope, hopefully assisting the sufferer in physically feeling less pain. Various methods have been employed with success, including cognitive behavioral therapy, stress management skills, deep breathing techniques, and other psychological exercises that, when practiced regularly, can change one's thought patterns -- which, consequently, can change the perception and experience of pain. It is essential for each individual to find the right counselor, and the right method.

(3) Relaxation Techniques

This is a broad term, utilized in Western culture to describe everything from yoga, to deep breathing exercises, to meditation, to guided imagery, though any single one could justify a category in itself. Briefly described below are three proven techniques.

Guided Imagery:
Guided imagery is a technique employing mental pictures to replace negative thoughts and emotions with positive ones. Indeed, negative emotions have been linked with decreased immune response, and positive emotions with increased immune response. This technique has been used effectively, in conjunction with other treatments, for rheumatoid arthritis, cancer, and other painful illnesses. It has also been shown to slow heart rate, reduce stress, and stimulate the immune system -- any one of which can reduce pain.

Professional hypnotherapy is designed to "generate a state of deep relaxation in which there is a heightened receptivity to suggestion through the calm repetition of words and statements." Simple verbal suggestions applied during this time can help the patient block the sensation of pain, anxiety, fear, or other psychological issues that may be increasing, or causing, pain.

During a state of hypnosis, the patient's mind is fully aware, but the body is curiously relaxed. A deep state of relaxation is induced, pulse rate and breathing slows, and blood pressure drops. Self-hypnosis is also possible with the right training, enabling a chronic pain sufferer to induce the state whenever necessary.

Familiar to most of us, at least in name, meditation is a technique thousands of years old, with innumerable subtypes. The main forms of meditation are grouped under either "mindfulness" or "concentrative" meditation.

Mindfulness meditation makes one aware of various outside stimuli, but trains the mind not to react. In concentrative meditation, the practitioner focuses on a single sound, object, or activity, such as one's breath. Both bring about a calm, tranquil state when practiced over time, and focus awareness in the present moment -- not anxieties or pain associated with the future or past.

When applied with proper technique, meditation has been shown to be an effective management strategy for reducing pain, decreasing anxiety and stress, and controlling conditions such as blood pressure. Classes are recommended to gain the full benefit.

Causes of chronic pain are challenging to diagnose, and the management of it even more difficult. But studies have proven that much power over this condition is in the patients' hands -- and that the mind has the final say in the level of pain experienced. After all, pain is not actually registered at the site of the injury, but in the brain itself. Through the disciplined application of techniques, and the diligence to find the ones that work best, chronic pain can be managed, and a higher level of functioning attained.
About the Author
Pat Carpenter writes for Precedent Insurance Company. Precedent puts a new spin on health insurance. Learn more at Precedent.com
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